Healthcare Provider Details

I. General information

NPI: 1982066593
Provider Name (Legal Business Name): SAMANTHA SPECHT CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2016
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 ROSARY DR
CORNING IA
50841-1683
US

IV. Provider business mailing address

603 ROSARY DR
CORNING IA
50841-1683
US

V. Phone/Fax

Practice location:
  • Phone: 641-322-3121
  • Fax: 641-322-4872
Mailing address:
  • Phone: 641-322-3121
  • Fax: 641-322-4872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberD130973
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: